Pragmatically Adapted Pediatric-Inspired Induction Regimen for Adults with Acute Lymphoblastic Leukemia in a Resource-Restricted Setting

This prospective observational study evaluated whether a pragmatically adapted pediatric-inspired induction regimen for adults with Philadelphia chromosome–negative acute lymphoblastic leukemia can be delivered safely in a Pakistani public-sector oncology center. We quantified diagnostic and therapeutic feasibility (access to immunophenotyping/cytogenetics/MRD testing, completion of induction, interruptions/abandonment) alongside early outcomes (remission, grade 3–4 toxicities, early mortality).